Conventionally, the Centers for Medicare and Medicaid Services (CMS) require funds in a Medicare Set Aside (MSA) account to be used exclusively for expenses related to its fiduciary interests, and require an annual report of expenditures. An estimated 95% MSA accounts are self-administered, placing responsibility on the claimant to properly use the funds and annually report to CMS. Non-compliance scenarios, in the event that a claimant does not properly use the funds or provide annual reports, may create serious CMS consequences for the claimant, including loss of future Medicare coverage until and unless Medicare is reimbursed for any monies misused in the MSA. When CMS discovers the non-compliance with the MSA terms and conditions and the claimant suffers the consequences of non-compliance, state law liability issues may arise for insurers, plaintiff firms, and other third party service providers that placed ungoverned funds totalling tens of thousands of dollars into the claimant's hands.